You’re not imagining things if it seems more kids are suffering from eczema, asthma, and hay fever these days.
In developed countries, these childhood atopic diseases have skyrocketed over the past few decades.
Today, at least one atopic disease affects one in four Australian children.
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It’s common for a sick child to exhibit symptoms of more than one of these conditions.
What’s an Atopic Disease?
Simply put, an atopic disease is a condition that results from being hypersensitive to allergens.
When exposed to allergens, an atopic child produces antibodies (known as immunoglobulin-E).
These antibodies trigger a cascade of cellular responses that ultimately result in symptoms.
This is known as a type 1 hypersensitivity reaction and is the underlying mechanism for all atopic disorders.
The physical symptoms of atopic diseases can range from mildly annoying skin rashes to life-threatening asthma attacks.
Though we still don’t completely understand the reasons for the increase in the prevalence of these conditions, we know it’s linked to many factors. These include genetics, lifestyle changes, environmental irritants and our diets.
Below I’ll explore the three most common of these diseases and offer parents and carers tips for treating affected kids.*
* Food allergy is a fourth childhood atopic disease for which we’ll do a separate blog post in the near future.
The most common form of eczema is atopic dermatitis, which presents as dry, itchy, and irritated skin.
It typically starts on the face, elbows and knees in small children. Older kids might get eczema in the folds of their elbows, hands and knees, their scalp, and behind their ears.
It can be pretty nasty stuff. Unfortunately, there’s no known cure.
Some common factors that aggravate eczema include:
- chemical irritations (chlorine, detergents and soaps – bubble baths are a definite no-no);
- sandpits, and
Food sensitivities can also be a culprit. Some of my younger patients avoid substances like artificial colours and preservatives, eggs, peanuts, seafood and soy.
However, it’s worth discussing with your doctor before you start excluding foods from your child’s diet.
We do know that early introduction of ‘allergenic’ foods is important. It’s a counter-intuitive prevention tactic, but you can introduce the same foods you might seek to avoid before your child is six months old.
Please consult your GP before heading down this path.
Eczema Treatment Tips
Try these simple home remedies for baby or child eczema:
- Keep them cool, especially on hot days.
- Moisturise their skin daily, or more often if needed, especially after playing outside or bathing.
- Use antihistamines and cold flannels to reduce itching and scratching.
- Observe and note foods that make eczema worse.
You can also apply topical creams prescribed by your GP, such as cortisone-based treatments.
Some parents are overly cautious about using this steroid, yet I assure you it’s very safe and effective.
For more detailed information, check out this fact sheet on eczema from The Royal Children’s Hospital Melbourne.
Asthma is a cruel disease characterised by the constriction of inflamed and swollen airways.
Added to the symptoms is increased mucus production, making it even harder for kids to get a lungful of air.
Acute asthma attacks, also known as asthma episodes, can occur when things get really bad. Such attacks are a leading reason for emergency department visits – often contributed to by sub-optimal management at home.
Unsurprisingly, these attacks can be terrifying for kids and parents alike.
It’s vital that you’re prepared and have an asthma action plan in place for your child, created in consultation with your GP. These potentially lifesaving plans give parents and carers a way to recognise symptoms and include instructions for when symptoms present.
You should review asthma action plans annually with your GP.
There’s a lot that can irritate your child’s airways and trigger asthma symptoms. Some of the critical factors include:
- air pollution and smoke;
- colds and respiratory infections;
- animals and pets;
- household dust and mites;
- pollen, and
- cold air.
As with other childhood atopic diseases, there isn’t a cure. Luckily, many children grow out of their asthma.
Asthma Treatment Tips
Above all else, call 000 immediately if your child has a severe asthma attack. Don’t try to fix the problem with inhalers or other medications.
Aside from this, you can help manage asthma in children by:
- making sure they carry their reliever puffer everywhere;
- teaching them how to use medication;
- learning asthma first aid;
- ensuring preventers are taken every day (if prescribed by a GP);
- using spacers;
- giving them annual flu shots, and
- staying calm in the event of an asthma attack.
For more information, check out this helpful factsheet from The Royal Children’s Hospital Melbourne.
Allergic rhinitis, commonly known as hay fever, results from an allergic reaction to airborne allergen particles getting trapped in the tiny hairs in the nose.
Though most of us make little fuss of this, prone children can suffer greatly.
Uncontrolled sneezing, itchy ears, nose and throat, red eyes and headaches are common symptoms. Often it won’t go away on its own.
Untreated hay fever can lead to all kinds of problems including sleeplessness, acute eye infections, and poor concentration at school.
Unfortunately, many kids with asthma also suffer from hay fever. The trigger factors are pretty much the same for both childhood atopic diseases.
High pollen count days are a nightmare!
Limiting irritation factors is your best weapon in reducing symptoms of flare-ups:
- Get pets out of the house.
- Avoid smoking around kids.
- Close windows and doors.
- Don’t mow the lawn.
Hay Fever Treatment Tips
You’ll probably hear of many possible hay fever treatments for children and babies. I advise sticking with methods that have scientific evidence of their effectiveness.
Some of these include:
- looking for obvious hay fever aggravators and eliminating the source;
- nasal sprays;
- non-sedating antihistamines;
- washing your child’s hands and bathing their eyes throughout the day;
- using eye drops to relieve itchy eyes;
- smearing Vaseline around the nose to help trap allergens, and
- giving your child a spoonful of locally produced honey each day may help in some instances.
In severe cases, your GP may suggest allergen immunotherapy as an option to explore. It involves gradual repeated exposure to specific allergens over time, usually years. The theory is that your child will produce less immunoglobulin-E in response to the allergens, and this will reduce the atopic symptoms.
Check out this fact sheet from the Australasian Society of Clinical Immunology and Allergy for more detailed information.
Dr Greg Clugston is a father and local GP at Doctors of South Melbourne.
He has a special interest in chronic childhood diseases and has extra training in paediatrics.